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| Sample Referral Form |
Each team will need to determine its own specific requirements regarding eligibility for a technology assessment according to the requirements of the law and of the agency supporting the child.
Interviews with the family and early childhood personnel, usually conducted during telephone conversations, can also help determine a child's eligibility for assessment. Since qualifying conditions for early intervention can vary depending on a state's policies, information gathered from these interviews will often clarify certain conditions that may allow a technology assessment based on eligibility criteria for that state.
Part of the pre-assessment process is gathering background information on the child.
This includes completion by the family of a form developed by Project TTAP which provides personal data, diagnosis and medical information, the reason for the assessment, information on the childs behaviors, the childs physical status, communication abilities, seating requirements, and previous experience with switch-operated toys and computer equipment. This form is used by team members as they plan activities for the evaluation.
| View Background Information PDF |
Along with the Background Information form, the family is asked to complete a Consent Form to indicate permission for team members to access records and photographs of the child.
| View Consent Form PDF |
Once the family signs the Consent Form, the team can then review pertinent information, such as evaluation reports and the IEP or IFSP, from the childs files. Also the family and/or teacher is asked to provide a short videotape which shows the childs normal activities either at home or at school or both places, if possible. Viewing the videotape and reviewing the background information is an important part of the assessment planning process.
Therapy Reports
Reports may be included from the physical therapist, occupational therapist, and/or speech/language specialist. Information about the child's disability, positioning, gross and fine motor skills, communication skills, and recommendations for activities of daily living may be provided.
Medical Records
A letter from the child's physician, medical history and development, a clinical summary, and an individual habilitation plan fact sheet may be included.
IEP/IFSP
This document will contain the current goals and objectives for the child. The assessment team will need to use this information to determine the appropriate technology that will help the child achieve these established goals. For a child younger than three, an Individual Family Service Plan will be included in the child's records.
To assist the team in planning the assessment, a form developed by TTAP, Information Compiled from the IEP, can be used.
| View Information Compiled from the IEP PDF |
Background information needed from the child's family or teacher includes a 10-20 minute videotape of the child showing activities at school or at home. This videotape provides additional information to the team about the child's interests and abilities and should show the child participating in activities of daily living. The tape will give the team information about the child's play, social interaction, communication, physical abilities, functional behavior, and attention span.
In order to get the best quality videotape possible, Video Production Tips may need to be provided to the family or teacher.
| View Video Production Tips PDF |
After reviewing the background information, the team coordinator telephones the family to clarify necessary information or to obtain information the team does not already have about the child. The Parent Telephone Interview form can be used as a guide in obtaining needed information.
| View Parent Telephone Interview Tips PDF |
The assessment coordinator may also discuss dates and times for the assessment and remind the family to bring special seating and positioning materials and any favorite toy that would make the child more comfortable on the assessment day.
Coordinating the varying schedules of all team members is one of the most difficult and time-consuming tasks that the assessment coordinator faces. The assessment should be scheduled at the convenience of the family and the assessment team members. The best day and time for the family is determined first. Obtaining several possible dates from the family prior to contacting other members provides the flexibility necessary to coordinate the entire team's schedule. Although scheduling may be tedious, attendance of the entire team is important to a successful assessment.
When a date and time for the assessment are agreed upon by all of the team members, letters of confirmation should be sent to the family and each individual team member.
This letter should include the date, time, and location of the assessment. In the family's letter include a reminder to bring items that the child may need during the assessment. If the child has a wheelchair, the tray will be important for placement of adaptive devices. Adaptive seating material regularly used by the child will also be needed during the assessment. Communication aids which the child depends on daily and a favorite toy will also be useful on the assessment day.
Core Team MeetingAfter collecting initial information, the assessment coordinator arranges a meeting of the Core team members at least a week before the assessment. During this meeting, the Core team plans the assessment and makes decisions about the software, hardware, adaptations, peripherals, and activities to use during the assessment.
The team reviews the background information and the videotape of the child. During the video, the core team members focus attention on:
Team members can use the Video Observation form to guide their review of the videotape.
| View Video Observation Form PDF |
Reviewing the background information and videotape gives the Core team members an idea of what the child will be capable of doing during the assessment.
The team discusses possible strategies and activities for the assessment as they review the child's abilities. The child's cognitive ability and motor function will be considered as the team plans the assessment. Four major considerations by the team during planning are:
Input method
Depending on the child's motor abilities, a switch or touch tablet may need to be considered instead of mouse or keyboard input. A variety of switches should be available. The team should have any foreseen adaptations, such as switch mount or materials for stabilizing the child's arm and hand movements, available for the assessment.
For more information on input devices, see Adaptations Workshop.
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View Adaptations Workshop |
Software
Software selection will depend on what type of input method is used and the child's cognitive level. The team should discuss whether to begin with very simple programs or more complex ones. Software should offer different levels of stimuli to test the child's interest. Also software should be available which goes slightly beyond the child's present level so that recommendations for future skills can be made. When selecting software to use for an assessment, consider whether the program is:
- developmentally appropriate
- graphically and/or visually appealing
- able to be customized for individual use
- versatile
- able to be used with alternate input devices
Adaptations
The team tries to foresee all needed customizations so that any modifications or overlays can be made ahead of time. Positioning materials, such as a switch holder, switch mount, Dycem, and slant board need to be available. Overlays for IntelliKeys or Key Largo should be created before the assessment and ready to use with the child.
Activities
The team plans activities considering the goal, device, software, materials, adaptations, and procedures to be used. An Assessment Activity form can be used as a guide when developing activities.
View Assessment Activity PDF
After the team has discussed the possible equipment, software, adaptations, and activities which may be used with the child, a tentative agenda can be established. The agenda includes planned activities and break periods. The Assessment Agenda form can be used as a guide by the team.
| View Assessment Agenda Tips PDF |
This agenda is then discussed during the opening meeting on the assessment day and any needed revisions are made at that time.
The computer, adaptive input devices, an adjustable table and adaptive materials should be gathered and set up either the day before the assessment or well in advance on the assessment day. Equipment will need to be tested and materials should be organized according to the tentative agenda.
| Procedures During Assessment |